Integrating the ONE CALL Statewide HIV Call Center. Presented by: Tyffany Evans Coleman

Transcription

1 Integrating the ONE CALL Statewide HIV Call Center Presented by: Tyffany Evans Coleman Tyffany Evans Coleman - ONE CALL IAPAC 2016

2 Conflict of Interest Disclosure Tyffany Evans Coleman, BS,BA No Conflicts. Tyffany Evans Coleman - ONE CALL IAPAC 2016

3 ONE CALL Overview ONE CALL toll-free statewide HIV referral line implemented from June August 2015 Utilized UNC Healthlink, an existing call center For HIV infected individuals and non HIV medical providers/clinicians Trained nurses assisted with HIV referrals

4 Why ONE CALL? Source: NC DHHS Communicable Disease Service Unite 2015

5 Why ONE CALL? (continued) Stigma and fear of being judged by healthcare professionals are important barriers to HIV care [McCoy, 2009]. Making an active referral (calling with clients to schedule appointments) was the single factor facilitating early linkage (<30 days from diagnosis) in a retention in care intervention for young MSM of color. Emotional and practical support at the time individuals learning of their HIV diagnosis makes a significant impact.

6 ONE CALL Implementation Card to Care (C2C) ONE CALL Call line Piloted in 9 Nurse advice line Post surgical follow ups Finding a doctor UNC HealthLink offering free CD4 cell count and HIV viral load testing/results Systems Linkage and Access to care in NC Multiple Interventions NCLINK counties with highest HIV rates, later expanded statewide

7 ONE CALL Goals Put callers at ease Reassure those that are newly diagnosed Help connect callers to clinics suited to their needs Facilitate connection between callers and HIV providers Encourage callers to speak to someone at clinic of their choice about concerns before their fist appointment. Tyffany Evans Coleman - ONE CALL IAPAC 2016

8 Essential Components of ONE CALL Marketing ONE CALL Script Website Provider Directory Staff Training

9 Essential Components continued Marketing: business cards, local radio and, news stations, local newspapers, Get-Real- Get-Tested commercial Website: program services, HIV testing locations Staff Training: HIV, ONE CALL program, providing referrals via script

10 ONE CALL HIV Provider Directory Clinic Location/ Hours of Operation Ryan White Funded Accepted Insurance Uninsured Resources Social Worker Financial Counselor Appointments by Referral Tyffany Evans Coleman - ONE CALL IAPAC 2016

11 Updated Directory of NC HIV Clinics HIV Providers based on existing lists in 2012 HIV Providers updated October December 2013

12 ONE CALL Script Interpersonal delivery Information on HIV/related services Collected Data Demographic HIV treatment history Barriers to care Referral preference Reassurance Messaging Tyffany Evans Coleman - ONE CALL IAPAC 2016

13 Providing Reassurance Many people are concerned about the costs of HIV care. Do you have medical insurance? Yes Most insurance plans will cover the costs of HIV tests and treatment. If you are concerned about your insurance, you can call a clinic before your appointment to ask questions. No You are not alone. Many HIV clinics have financial counselors that help people access programs to get the care they need. Tyffany Evans Coleman - ONE CALL IAPAC 2016

14 Nurse Interaction with Callers Immediate Intervention HIV Counseling Addressing Barriers to Care Tailored referrals to HIV Care Resource Guide Tyffany Evans Coleman - ONE CALL IAPAC 2016

15 Call Volumes Results Barriers to Care 181 Total calls 59 Calls, excluded 3 no stated need 5 not related to HIV 51 incomplete 122 HIV Related, completed calls Requesting: 56% HIV clinic referrals 25% other HIV related services 19% Miscellaneous Talk to a doctor General Information 66% (n=81) reported no barriers Most frequently reported barriers (n=41) Costs (63%) Prior mistreatment (24%) Transportation (24%)

16 Caller Demographics Mean Age: 35 Range: % 1% 13% Gender 3% 2% 2% 16% Race 26% 59% 14% 63% Male Female Trans Male Trans Female No Data Black White Hispanic Alaskan/Native American Decline No Data

17 All Callers 104/122 (85%) of callers received HIV referrals Referrals 23% (n=24/104) to HIV clinic 32% (n=33/104) to case management (CM) 45% (n=47/104) to both Callers New to Care 16 (13%) callers had never seen an HIV provider 15/16 (94%) were referred to an HIV provider during the call

18 Referrals continued PLWH Who had Never seen an HIV Provider (n=16) Referrals N % HIV PCP/Clinic + CM HIV case management (CM) 2 13 HIV medical care (PCP/Clinic) 1 6 No Referral 1 6 PLWH Who Had Seen an HIV Provider (n=77) Referrals N % HIV PCP/Clinic + CM HIV case management (CM) HIV medical care (PCP/Clinic) No referral 4 5

19 Success and Challenges Existing call line Collaborators Referrals Simultaneous referral processes implemented during start of ONE CALL Program uptake Technology

20 Conclusions ONE CALL intervention demonstrated feasibility Tailored referrals to meet callers needs Successful in rapid linkage, especially for individuals new to care Increased promotion in settings without an active linkage process may have increased reach/uptake Access to a centralized and routinely updated HIV provider database with both private and publicly funded facilities is essential

21 Acknowledgements This project was funded through Health Resources and Services Administration Special Projects of National Significance Program, NC-LINK (HA15148). Co- Principal Investigators: Jacquelyn Clymore, MS, State AIDS Director, NCDHHS and Evelyn Byrd Quinlivan, MD. ONE CALL DEVELOPMENT TEAM Cynthia Gay, MD,MPH UNC Chapel Hill, Site PI Joaquin Carcano, BS UNC Chapel Hill Elisa Klein, MPH, MSW UNC Chapel Hill Anna LeViere, MPH UNC Chapel Hill Julia Coleman, RN UNC Healthcare UNC Healthlink ONE Call Nurse Specialists Nancy Shaw, Nancy Gates, Jillian Adams, Mary Kerr UNC School of Journalism Austyn Canada, Jamal Little, Chesley Kalnen, Nicole Otto Others Collaborators, staff, and program participants Tyffany Evans Coleman - ONE CALL IAPAC 2016

22 Thank